Is it better to sleep on your back, belly, or side?

Think a firm mattress is better for back pain? Not necessarily. All that really matters is that you find one that’s comfortable and fully supports your body without creating pressure points, says Arya Nick Shamie, M.D., chief of orthopedic spine surgery at the University of California Los Angeles in Santa Monica. (See our new mattress Ratings to find a mattress that’s right for you.) But sleep posture can make a difference for back pain, and for several other common ailments, including snoring and heartburn.

Back pain: Sleep on your back or side

That’s generally recommended for people who have back pain, according to a recent article in Applied Ergonomics. When on your back, keep your spine aligned by placing a small pillow under your head and a pillow or a firm foam wedge under your knees to maintain the natural curve of your lower back. If on your side, draw your knees up and lay a pillow lengthwise between your legs to prevent the inner side of the knees from hitting each other, which can be uncomfortable.

Neck pain: Sleep on your back or side

When on your back, support the natural curve of your neck with a rounded neck pillow, and place a flat pillow beneath your head, according to research at Harvard Medical School. When on your side, keep your spine straight by using a pillow that’s higher under your neck than your head.

Shoulder pain: Sleep on your back or unaffected side

When on your back, place a small pillow beneath your injured shoulder. When on your unaffected side, hug a pillow (or a friend).

Hip pain: Sleep on the unaffected side

Draw your knees up and lay a pillow between your legs to keep your hips aligned and to prevent your knees from touching.

Knee pain: Sleep on your back or side

When on your back, place a pillow behind your knees. When on your side, keep your knee in a comfortable, flexed position.

Heartburn: Sleep on your left side

Heartburn is caused when the ring of muscle at the top of your stomach doesn’t fully close, allowing caustic stomach acid to leak back into your esophagus. That’s particularly likely when you lie down after a big meal, which is why heartburn symptoms are often worse at night and why it often interferes with sleep. Lying on your left side positions the esophagus in such a way that it makes it harder for the acid to escape the stomach. It can also help to elevate the upper half of your body by placing 4- to 6-inch blocks under the head of the bed, or by putting a wedge-shaped support under the mattress. Don’t use extra pillows under your head since that doesn’t reposition your stomach or esophagus, but can cause a stiff neck.

Snoring: Sleep on either side

Try sleeping on one side or the other, not your back. Your throat muscles relax when you sleep on your back, and your tongue can fall backward. That narrows your throat, which gives your breathing the characteristic snoring sound. This simple sleep position trick could help control sleep apnea, a severe form of snoring in which the airway can become partially or fully blocked when sleeping on your back. As a result, your blood oxygen level can drop, causing the release of stress hormones that increase the risk of high blood pressure and heart disease.

—Doug Podolsky

Mattress Recommendations

Our top-scoring innerspring mattress, the Serta Perfect day iSeries Applause, $1,075, is very good for side and back sleepers and was excellent in our durability tests, which simulate eight years of use. We named the Serta a CR Best Buy.

Our top-rated foam mattress is the Sleep Number Innovation Series i8 bed Pillowtop, $3,000, which was very good for side sleepers, excellent for back sleepers, and has excellent durability.

But for almost a quarter of that price, you can buy the Novaform Memory Foam Collection Serafina 14” for $800 at Costco, which was very good for side and back sleeping and a CR Best Buy.

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